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Risk Assessment and Early Detection

Riesgos y = Como Detectar el Cáncer Mas Temprano
Ana Maria López, MD, MPH, FACP <= /div>
Associ= ate Professor of Clinical Medicine and Pathology
Medical Director, Arizona Telemedicine Program
Medical Director, Women's Health Initiative <= /span>
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Breast Cancer Incidence
Incidencia de Cán= cer de Seno
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C= asos de cáncer de seno en US
Edad de Mujer
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file:///C:/B13369F7/9.7_files/slide0008.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Asthma
Risk Factors
Riesgos<= /b>
uFamily History of= Breast Cancer
<= span style=3D'font-size:92%;visibility:hidden'>u = ;
<= span class=3DHBB style=3D'position:absolute;left:-9.7%;top:.39em'>uAge at menarche
<= span style=3D'font-size:83%;visibility:hidden'>u = ;
uAge a= t birth of first child
<= span class=3DHBB style=3D'position:absolute;left:-9.7%;top:.39em'>uAge at menopause
<= span style=3D'font-size:83%;visibility:hidden'>u = ;
<= span class=3DHBB style=3D'position:absolute;left:-8.43%;top:.39em'>uBeni= gn breast disease
<= span class=3DHBB style=3D'position:absolute;left:-9.3%;top:.39em'>uHi= storia familiar
<= span style=3D'visibility:hidden'>u
<= span style=3D'font-size:67%;visibility:hidden'>u&= #13;
<= span class=3DHBB style=3D'position:absolute;left:-8.29%;top:.39em'>uE= dad de menstruación
<= span style=3D'font-size:83%;visibility:hidden'>u&= #13;
= uEdad que nació su primer hijo
<= span class=3DHBB style=3D'position:absolute;left:-7.96%;top:.39em'>uE= dad de la menopausia
<= span style=3D'font-size:83%;visibility:hidden'>u&= #13;
uEnfermedad benigna de seno
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Risk Factors
Arrié= sguese los Factores
<= span class=3DHBB style=3D'position:absolute;left:-9.7%;top:.39em'>uRadia= tion
<= span class=3DHBB style=3D'position:absolute;left:-9.7%;top:.39em'>uObesi= ty
<= span class=3DHBB style=3D'position:absolute;left:-9.7%;top:.39em'>uHeigh= t
uOral contraceptive use
uPostm= enopausal estrogen-replacement therapy
<= span class=3DHBB style=3D'position:absolute;left:-9.7%;top:.39em'>uAlcoh= ol Use
<= span class=3DHBB style=3D'position:absolute;left:-9.7%;top:.39em'>uRa= diación
<= span class=3DHBB style=3D'position:absolute;left:-9.7%;top:.39em'>uOb= esidad
<= span class=3DHBB style=3D'position:absolute;left:-9.7%;top:.39em'>uAl= tura
<= span class=3DHBB style=3D'position:absolute;left:-9.66%;top:.39em'>uA= nticonceptivo oral
<= span class=3DHBB style=3D'position:absolute;left:-8.29%;top:.39em'>uT= erapia con estrógeno
<= span style=3D'font-size:83%;visibility:hidden'>u&= #13;
<= span style=3D'font-size:83%;visibility:hidden'>u&= #13;
<= span class=3DHBB style=3D'position:absolute;left:-9.7%;top:.39em'>uUs= o de alcohol
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Hereditary Breast Cancer
Cánce= r de Seno Hereditario
u< = 10% familial
<= span class=3DHBB style=3D'position:absolute;left:-9.7%;top:.39em'>uEarly= age of onset
<= span class=3DHBB style=3D'position:absolute;left:-9.7%;top:.39em'>uBilat= eral
uCanc= er of the colon, ovary, uterus
<= span class=3DHBB style=3D'position:absolute;left:-8.96%;top:.39em'>uAuto= somal dominant
<= span class=3DHBB style=3D'position:absolute;left:-9.7%;top:.39em'>u50% l= ifetime risk
u
<= span class=3DHBB style=3D'position:absolute;left:-9.0%;top:.39em'>u&l= t; 10% familiar
<= span class=3DHBB style=3D'position:absolute;left:-8.84%;top:.39em'>uD= iagnostico de jóven
<= span class=3DHBB style=3D'position:absolute;left:-9.0%;top:.39em'>uBi= lateral
uCáncer del intestino, ovario, el útero
<= span class=3DHBB style=3D'position:absolute;left:-7.9%;top:.39em'>uTr= ansmision dominante
<= span class=3DHBB style=3D'position:absolute;left:-9.0%;top:.39em'>u50% probabilidad
<= span style=3D'visibility:hidden'>u
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Increased Chance of BRCA Mutations / Quien tiene riesgo para la
Mutaciones d= e BRCA
uMultiple cases of early onset breast cancer
u
uBreast and ovarian cancer in the same person
u=
uBilateral breast cancer
u
uAshkenazi Jewish heritage
u=
uMale breast cancer
uCasos del cáncer de seno de edad jóven
<= span style=3D'font-size:75%;visibility:hidden'>u&= #13;
<= span style=3D'font-size:83%'>uCáncer d= e seno y de ovário
<= span style=3D'font-size:108%;visibility:hidden'>u=
<= span style=3D'font-size:83%'>uCáncer d= e seno bilateral
<= span style=3D'font-size:75%;visibility:hidden'>u&= #13;
<= span style=3D'font-size:83%'>uHerencia jud&ia= cute;a Askenazíta
<= span style=3D'font-size:83%;visibility:hidden'>u&= #13;
<= span style=3D'font-size:83%'>uCáncer d= e seno masculino
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High-Risk Factors /
Factores de alto riesgo<= /i>
(RR=3D3X)
<= span class=3DHBB style=3D'position:absolute;left:-10.69%;top:.39em'>uAge= ( >40 yo)
uPrevi= ous history of breast cancer
<= span class=3DHBB style=3D'position:absolute;left:-10.69%;top:.39em'>uFam= ily history
uBre= ast biopsy: hyperplasia/atypia
<= span class=3DHBB style=3D'position:absolute;left:-10.69%;top:.39em'>uLow Parity
<= span class=3DHBB style=3D'position:absolute;left:-10.69%;top:.39em'>uLCI= S
<= span class=3DHBB style=3D'position:absolute;left:-9.75%;top:.39em'>uE= dad ( >40 yo)
uH= istoria previa del cáncer de seno
<= span class=3DHBB style=3D'position:absolute;left:-9.75%;top:.39em'>uH= istoria familiar
uB= iopsia de seno previa con hyperplasia/atypia
<= span class=3DHBB style=3D'position:absolute;left:-9.75%;top:.39em'>uP= ocos partos
<= span class=3DHBB style=3D'position:absolute;left:-9.75%;top:.39em'>uL= CIS
<= span style=3D'visibility:hidden'>u
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Moderate Risk /
Modere el Riesgo
(RR=3D 1.2 - 1.5)<= /span>
<= span class=3DHBB style=3D'position:absolute;left:-8.96%;top:.39em'>uMens= truation history
<= span class=3DHBB style=3D'position:absolute;left:-9.7%;top:.39em'>uOral estrogens
uHisto= ry of ovarian, colon, endometrial cancer
<= span class=3DHBB style=3D'position:absolute;left:-9.7%;top:.39em'>uDiabe= tes
<= span class=3DHBB style=3D'position:absolute;left:-9.7%;top:.39em'>uAlcoh= ol
uHi= storia de menstruación
uE= strógenos orales
uC= áncer de ovário, intestino, útero =
u=
uD= iabetes
uA= lcohol
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Protective Factors /
Factores protectores
uAsian ancestry
uTerm pregnancy before 18
uEarly menopause
uOopherectomy < 37 yo
<= span class=3DHBB style=3D'position:absolute;left:-7.9%;top:.39em'>uLa ascendencia asiática
uPa= rto antes de 18 años
<= span style=3D'visibility:hidden'>u
uLa menopausia temprana
<= span style=3D'font-size:33%;visibility:hidden'>u=
<= span class=3DHBB style=3D'position:absolute;left:-7.84%;top:.39em'>uO= oferectomía <37 años
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file:///C:/B13369F7/9.7_files/slide0019.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Asthma
Early Detection /
Como Detec= tar el Cáncer de Seno Temprano
uSBE – auto examen
uCBE – examen clínico
uMammography / Mamografía
= –Digital
= –Film / Película
uUS - ultrasonido
uMRI
uDuctal lavage / Lavado Ductal
uFiberoptic ductoscopy / Ductoscopia
------=_NextPart_01C6737A.3CD2CC50 Content-Location: file:///C:/B13369F7/9.7_files/slide0020.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Asthma
Breast Cancer Screening /
Detectar el Cáncer de Seno
uMonthly Self Breast Exam
= –>20 yo
uClinical Breast Exam
–every 3 years to 40 yo
= –every year >40 yo
u
uAuto examen mensual de seno
= –> 20 años
uExamen clínico de seno
–cada tres años hasta 40 años de edad
–Cada año después de 40
------=_NextPart_01C6737A.3CD2CC50 Content-Location: file:///C:/B13369F7/9.7_files/slide0021.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Asthma
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Mammography Recommendations/
Recomendacio= nes de mamografía
uAnnual mammo aft= er age 50 u40-49, annually or bi-annually
<= span class=3DHBB style=3D'position:absolute;left:-9.7%;top:.39em'>uFN 15= %
uMamograma anua= l después de 50 años u40-49, anualmente o cada otro año
<= span class=3DHBB style=3D'position:absolute;left:-9.7%;top:.39em'>uFN 15%
<= span style=3D'visibility:hidden'>u
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Digital Mammography /
Mamografía Digital
uTechnical advantages
–e= asier image retrieval
–
–b= etter storage options
–
–ability to transmit/manipulate images
uLas ventajas técnicas
–recuperación más fácil de = imagen
–mejores opciones de almacenamiento
–habilidad te transmitir/manipular las imágenes
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Mammography: Annual >40 yo / = Mamografía: Annual >40 años
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MRI
MRI demuestra el cáncer en el seno
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